CASE 510: MITTELSCHMERZ SYNDROME, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

Woman 27 yo with  hypogastric pain. Ultrasound in emergency detected bleeding intra abdomen.

US 0=  fluid under liver area in  Morrison’s space.

US 1  = sagittal scanning at pelvis,  thickening of endometrium  and an amount of blood around pelvis.

US 2 =  transverse section at pelvis, right ovary too big  in comparison  to left one.

US 3 =  sagittal  mass at right  ovary.

Emergency blood test report  Hct 20%;  Hb 10 g/L; beta HCG  negative.

MRI 1 of abdomen detected  one mass at right  ovary.

MRI 2=  sagittal scanning of pelvis, retrouterus bleeding.

MRI 3=  frontal view of  right/left ovaries,  bleeding from right ovary.

Diagnosis is  bleeding from right ovary in Mittelschmerz syndrome.

Operation  removed 1000 ml blood clot  and right ovarian  rupture (photo) .

Mittelschmerz (German: "middle pain") is a medical term for "ovulation pain" or "midcycle pain". About 20% of women experience mittelschmerz, some every cycle, some intermittently.